Turning 90

This week we celebrated my father-in-law’s 90th birthday. It is a testament to the cardiac care he has received over several decades.

By the family account, he has undergone PCI (not described as such), had stents collapse (I doubt that), been diagnosed with heart failure (true) and is on warfarin (reputedly because of the stents … I would add atrial fibrillation—a common companion with heart failure—to the lineup instead). He has two care teams, one in Indiana and one in Florida.

This must be a challenge for physicians in either state. Are symptoms new or a result of poor compliance to another physician’s orders? Are his records up to date? What is his current list of drugs, and in this perpetually changing polypharmacy, are they compatible? Are specialists and primary care physicians able to share results, either within states or across them?

Add to this a broken hip last year, a stint in a rehab facility and a preference for Veterans Affairs care when it costs less.

This is likely a fairly common scenario for care teams: a complex, elderly patient with some lifestyle choices that make continuity of care a little harder. Yet it works.

Besides the fact that he could blow out the candles (two, but still) at 90, he demonstrated his health and independence. He displayed his exercise regime of leg lifts, stretches and balance maneuvers, which were pretty impressive. He relayed his doctor’s orders and his efforts to remain adherent. In this regard he may be atypical, since medication adherence is often poor and becomes even more so as the number of pharmaceuticals adds up.

But what has become apparent is that his doctors take the time and effort to involve him in his care. He knows that ultimately he is responsible for filling prescriptions, keeping track of what he takes daily, exercising, following orders and staying in contact with his doctors. He knows it takes a team; his family, his caregivers and himself.

I congratulate and thank you all.

Candace Stuart

Cardiovascular Business, editor